Claim Management System (CMS) Wiki

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Claim Manufacturer Denied ======
The manufacturer has denied the consumers claim form. 

You as the provincial administrator will need to review and make a final decision.
  * Select the **claim number** or the **Claim OEM Denied** button
**NOTE:** They show slightly different things, but give you the same functionality.

{{::claim_oem_denied_button.png|}}
===== Select Claim Number =====
Here you will be able to view the claim form, documents and reason for denial.
===== Select Claim OEM Denied Button =====
Here you will see a __summary__ of the problem(s), document(s) and communication available, along with the reason for denial.
===== Actions =====
You will notice you still have the [[Reassign Arbitrator]] button and you now have a new one, which is [[Request Technical Inspection]].
===== Statuses =====
There are a number of options for handling the denial, select the appropriate one. 

{{::change_status_claim_oem_denied.png|}}
  * [[Eligibility Hearing Required]]: The manufacturer does not believe the claim is eligible, but the PA believes the consumer meets the CAMVAP eligibility requirements and schedules an eligibility hearing.
      * A [[Letters|manual letter]] should be sent to consumer, manufacturer and arbitrator outlining why an eligibility hearing has been scheduled and the hearing details.

  * [[Closed|Closed Claim Ineligible]]: Based upon the review of the information provided by the manufacturer the claim is considered ineligible and will be closed.
      * A [[Letters|manual letter]] should be sent to consumer and manufacturer indicating that the claim has been closed and why.

  * [[Closed|Closed Conciliated]]: The consumer and the manufacturer have come to an agreement prior to arbitration.
      * A [[Letters|manual letter]] should be sent to consumer, manufacturer and arbitrator indicating that the claim has been closed and why.

  * [[Closed|Closed Withdrawn]]: The consumer has decided to remove their case from the arbitration process
      * A [[Letters|manual letter]] should be sent to consumer, manufacturer and arbitrator indicating that the claim has been closed and why.


Provide additional notes as you see fit and save the status change.  Please use caution when recording claim notes as all parties have access to the notes.
 {{::status_notes.png|Status Notes}}
     NOTE: Once the status change has been made it cannot be altered.
Claim Management System (CMS) Wiki

User Tools

Site Tools

Page Tools
